Measuring Confrontation During Recovery

Funding: NIDA R21 DA023677

The Alcohol and Drug Confrontation Scale (ADCS) is a new 72-item instrument that measures a construct of confrontation specified as warnings to an individual about potential harm if she/he does not make changes to establish or maintain abstinence from drugs and alcohol. Unlike most examinations of confrontation, the ADCS assesses confrontation from sources beyond treatment staff, such as recovering peers, family, friends, and professionals in ancillary roles (e.g., criminal justice and social welfare staff). A qualitative component will undertake new in-depth interviews on a targeted sample of 40 participants to help explain why participants’ experiences of confrontation vary over time. Findings will help treatment providers maximize confrontation associated with positive outcome and minimize counterproductive confrontation. This study builds on previous Alcohol Research Group studies that describe the role of institutional and interpersonal pressure in alcohol treatment entry. The research goes beyond current studies in two ways. First, it introduces a new, multidimensional way to measure confrontation that individuals receive about their alcohol and drug use. Second, it assesses confrontation longitudinally rather than at baseline only. This will allow a description of the impact of confrontation during and after treatment in addition to treatment entry. Consistent with our previous studies, confrontation is assessed from multiple sources, including personal relationships (e.g., family and friends), treatment relationships (client peers and staff), and outside institutions (e.g., criminal justice and mental health). Findings will help clarify the types of confrontations that facilitate recovery from addiction and those that are counterproductive.